Inter‐ and Intra‐rater Agreement of Dermatologic Ultrasound for the Diagnosis of Lobular and Septal Panniculitis

Abstract

Objectives-Dermatologic ultrasound (US) may aid in the diagnosis and classification of panniculitis. The purpose of this study was to assess the capability of dermatologic US for subtyping mainly septal/lobular panniculitis.Methods-A multicentric and prospective study of the inter-and intra-rater agreement of dermatologic US for subtyping panniculitis was conducted among 4 clinicians with experience in dermatologic US and a radiologist specialized in dermatologic US. Clinicians recruited patients and performed dermatologic US examinations of the most substantial lesion and punch biopsies. A histologic study was considered the reference standard. Then the images were blindly evaluated by all researchers. For intra-and inter-rater agreement, Cohen and Fleiss κ values were calculated.Results-Sixty-four patients were included. The Cohen intra-rater κ was 0.74. Sensitivity and specificity for lobular panniculitis were 85.19 and 88.57, respectively. The Fleiss inter-rater κ was 0.47. Limitations of the study included the small number of patients and differences in evaluators and their dermatologic US equipment.Conclusions-This study supports the use of US for diagnosing panniculitis. For subtyping panniculitis, the intra-rater correlation was good. Improvement of inter-rater agreement may depend on access to clinical information, dynamic images, a better definition of criteria, homogeneous configurations of the devices, and the expertise of dermatologic US operators.

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

“…In other inflammatory skin diseases, such as panniculitis [376], pseudoxanthoma elasticum [377], atopic dermatitis [368], and sarcoidosis [378], US provides additional information that is useful for early diagnosis or follow-up.…”

Ultrasound in Sports and Occupational Dermatology

“…On color Doppler imaging, the degree of hypervascularity in the subcutaneous tissue may be variable, but it is usually low (Figures 3-5). 25,28 Cutaneous Inflammation, Folliculitis, and Mechanical Acne in Musicians: Fiddler's Neck The prevalence of dermatologic problems in musicians ranges from 20% to nearly 50%. 29,30 These alterations can be produced by chronic trauma or friction but by contact with irritants that come with the instruments.…”

“…On color Doppler imaging, the degree of hypervascularity in the subcutaneous tissue may be variable, but it is usually low (Figures 3–5). 25,28 …”

Scleroderma-panniculitis: view of the rheumatologist

“…Одними из перспективных методов первичной инструментальной диагностики, по нашему мнению, являются УЗИ и МРТ мягких тканей. В зарубежной литературе использование этих методов для выявления Пн описано в единичных исследованиях [26][27][28][29]. J. Romani и соавт.…”

“…J. Romani и соавт. [28] проанализировали данные гистологической картины и УЗИ уплотнений у 64 пациентов с Пн. Чувствительность и специфичность С О В P E М Е Н Н А Я Р Е В М А Т О Л О Г И Я № 2 ' 2 1 К Л И Н И Ч Е С К И Е Н А Б Л Ю Д Е Н И Я / C L I N I C A L O B S E R V A T I O N S УЗИ для диагностики ЛПн составили 85,2 и 88,6% соответственно, положительное отношение правдоподобия -7,45, а отрицательное отношение правдоподобия -0,16.…”